Sunday, July 15, 2012

Revision rhinoplasty is one of the more difficult types of surgeries in plastic surgery. There is significant scar tissue under the skin envelope of the nose between the skin and cartilage/bone. This makes healing more unpredictable compared to primary or first time rhinoplasty or nose surgery. In addition, if a septoplasty was performed, there may be limited cartilage to work with for grafts. Therefore alternative sources of cartilage need to be used.

I prefer to use the patient’s own cartilage when performing revision rhinoplasty. If there is insufficient septal cartilage for use, my first choice is to utilize ear cartilage. This is taken from the conchal bowl of the ear. The concha is the area just outside the ear canal and is a curved bowl shaped piece of cartilage. This cartilage is excellent for reconstruction and support of the nasal tip. This does not change the shape of the ear and the scar is located behind the ear and almost completely inconspicuous.

However, if a strong, straight piece of cartilage is needed, this may require rib cartilage. Rib cartilage is taken through a small 2 inch incision just above the breast line in women so that the scar is well hidden by a bikini or bra and just inside the crease in men. I will typically use rib cartilage as a last resort and favor a patient’s own cartilage rather than irradiated cadaveric rib cartilage. However, if a large piece of cartilage is necessary rib is the greatest source for grafting.

Dr. Funk is a rhinoplasty or nose job specialist in Houston and sees patients from Katy, Sugarland, Spring Cypress and Houston.